Individual
KAELYN HEATH
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
COTA/L
Contact information
Practice address
6502 19TH ST NE, TACOMA, WA 98422-3701
(253) 315-9111
Mailing address
6502 19TH ST NE, TACOMA, WA 98422-3701
(253) 315-9111
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
OC60197406
WA
Other
Enumeration date
11/18/2014
Last updated
11/18/2014
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